The incidence and prevalence of systemic hypertension are reaching global epidemic proportions. Despite a diverse pharmacologic armamentarium of agents to treat high blood pressure, suboptimal control remains a significant problem in as many as 43% of patients and this rate has not significantly improved over the past 2 decades. There ...

Although hypertension is uncommon in childhood, when present, clinicians should investigate the cause and manage appropriately, which can be challenging in children with renal disease. Our knowledge of normal homeostatic mechanisms of blood pressure control, such as the renin-angiotensin system or endothelial function, and the pathophysiology of these systems in ...

Drugs used to acutely lower blood pressure have specific indications and precautions for use. Clevidipine is a third-generation parenteral dihydropyridine calcium channel blocker that received United States Food and Drug Administration approval in August 2008 for blood pressure reduction when oral therapy is not feasible or desirable. Formulated as an ...

High blood pressure is a very common disease in hypercholesterolemic and diabetic patients and contributes to the increase in cardiovascular risk. Inhibitors of 3OH-3methyl-glutaryl-coenzyme A reductase are the most effective and widely used cholesterol-lowering drugs. They significantly reduce the risk of cardiovascular events and death in both primary and secondary ...

Moderate pressure appears to be necessary for massage therapy effects. Studies comparing moderate and light pressure massage are reviewed and they suggest that growth and development are enhanced in infants and stress is reduced in adults, but only by moderate pressure massage. The stimulation of pressure receptors leads to increased ...

Arterial hypertension is an important risk factor for the development and progression of cardiovascular disease (CVD). The renin angiotensin aldosterone system (RAAS) plays a crucial role in the pathophysiology of hypertension and associated complications. Direct renin inhibitors (DRIs) are novel antihypertensive drugs which inhibit the first step of RAAS. Aliskiren ...

To update the evidence-based recommendations for the prevention and treatment of hypertension in adults for 2010. For lifestyle and pharmacological interventions, randomized trials and systematic reviews of trials were preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering ...

The renin-angiotensin-aldosterone system (RAAS) is one of the main regulators of blood pressure, renal hemodynamics, and volume homeostasis in normal physiology, and contributes to the development of renal and cardiovascular (CV) diseases. Therefore, pharmacologic blockade of RAAS constitutes an attractive strategy in preventing the progression of renal and CV diseases. ...

The notion that eating chocolate would prevent or treat hypertension is appealing to many who produce and enjoy chocolate. Several studies have documented beneficial effects of dark chocolate on insulin action and endothelial function. However, the published studies on chocolate and blood pressure include a relatively small number of subjects, ...

Macronutrient and micronutrient deficiencies are very common in the general population and may be even more common in patients with hypertension and cardiovascular disease due to genetic, environmental causes and prescription drug use. The Hypertension Institute in Nashville, TN, has evaluated micronutrient deficiencies and oxidation status, in a group of ...

Guidelines for cardiovascular disease prevention recommend a non-pharmacological approach to reduce cardiovascular risk in those with elevated blood pressure. We assessed guideline adherence in hypertensives. This study was performed in the European Investigation into Cancer and Nutrition-NL cohort, consisting of 40,011 subjects. From 1993 to 1997, participants completed questionnaires (disease ...

Although inhibitors of the renin-angiotensin system are effective as first-line antihypertensive drugs in hypertensive patients with chronic kidney disease, they cannot completely prevent the progression of renal injury. Many animal studies, including our own, and a few human studies suggest that mineralocorticoid receptor blockade could inhibit the ongoing renal damage ...

Hypertension is a common complication of type 2 diabetes mellitus (T2DM), and is the main cause for T2DM-associated mortality. Although the stringent control of blood pressure is known to be beneficial in reducing the cardiovascular mortality of T2DM patients, drugs with both anti-hypertensive and anti-hyperglycemic effects are seldom reported. The ...

Subclinical organ damage is a very important aspect when assessing total cardiovascular risk in hypertensive subjects. Therapeutic strategies in those patients should consider treatment of hypertension-related cardiovascular and renal damage in addition to achieving the recommended blood pressure targets. l-carnitine (LC) is a naturally occurring compound that is administered exogenously ...

Hypertension is the most common cardiovascular condition in adults. It is also very common in athletes. When lifestyle changes fail, medications may be needed for the treatment of hypertension. When choosing a drug for antihypertensive therapy, providers should choose an agent that has favorable effects on blood pressure and minimal ...

Regardless of the mechanisms that initiate the rise of blood pressure, the development of structural changes in the systemic vasculature is the end result of established hypertension. Indices of small resistance artery structure, such as the ratio of tunica media to internal lumen, may have a strong prognostic significance in ...

Insulin resistance, dyslipidemia, hypertension, obesity, cardiovascular disease, and chronic kidney disease cluster together, and the incidence of all of these disease states is increasing throughout the world. Current strategies for hypertension management-including the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium antagonists, and thiazide diuretics-are effective for most patients. ...

The INTERACT pilot study demonstrated the feasibility of the protocol, safety of early intensive blood pressure lowering and effects on haematoma expansion within 6 h of onset of intracerebral haemorrhage. This article describes the design of the second, main phase, INTERACT2. To compare the effects of a management strategy of ...

In the past 4 decades, beta blockers (BBs) have been widely used in the treatment of uncomplicated hypertension and are still recommended as first-line agents in national and international guidelines. Their putative cardioprotective properties, however, derive from the extrapolation into primary prevention of data relative to the reduction of mortality ...

Hypertension is a mechanism-based toxic effect of drugs that inhibit the vascular endothelial growth factor signaling pathway (VSP). Substantial evidence exists for managing hypertension as a chronic condition, but there are few prospectively collected data on managing acute hypertension caused by VSP inhibitors. The Investigational Drug Steering Committee of the ...

Hypertension affects most hemodialysis patients and is often poorly controlled. Adequate control of blood pressure is difficult with conventional hemodialysis alone but is important to improve cardiovascular outcomes. Nonpharmacologic interventions to improve blood pressure include educating patients about limiting sodium intake, ensuring adequate sodium solute removal during hemodialysis, and achieving ...

Hypertension reigns as a leading cause of cardiovascular morbidity and mortality worldwide. Excessive reactive oxygen species (ROS) have emerged as a central common pathway by which disparate influences may induce and exacerbate hypertension. Potential sources of excessive ROS in hypertension include nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, mitochondria, xanthine oxidase, ...

This review addresses the use of the different antihypertensive agents currently available and some in development, and their effects on the vasculature. The different classes of agents used in the treatment of hypertension, and the results of recent large clinical trials, dosing protocols and adverse effects are first briefly summarized. ...

Although hypertension is the most prevalent treatable vascular risk factor, how it causes end-organ damage and vascular events is poorly understood. Yet, a widespread belief exists that underlying usual blood pressure can alone account for all blood-pressure-related risk of vascular events and for the benefits of antihypertensive drugs, and this ...

PURPOSE: The pharmacology, pharmacokinetics, efficacy, safety, dosage and administration, and place in therapy of clevidipine are reviewed. SUMMARY: Clevidipine is a new lipophilic, short-acting, third-generation dihydropyridine calcium channel blocker (CCB) approved for use in the management of acute hypertension when oral agents are not feasible. It exerts its hemodynamic effects ...

Context: Consensus guidelines recommend thiazides for first-line treatment in uncomplicated hypertension. Most patients require two or more drugs and little is known about the relative efficacy and outcomes of second-line treatments including thiazide. Objective: To compare differences in blood pressure, renal function and medical outcomes between commonly used two drug ...

In this observational cohort study, the authors assessed the achievement of treatment goals as defined in the Japanese Society of Hypertension's Guidelines for the Management of Hypertension (JSH 2004) among 2743 Japanese hypertensive patients who were followed for 1 year (follow-up rate of 82.6%). Median age was 72 years, and ...

Hypertension is highly prevalent and more difficult to treat in older individuals. Monotherapy alone is often not effective for the control of hypertension and single-pill combination therapy with 2 drugs having complementary mechanisms of action is needed in many older hypertensive individuals. The literature on management of hypertension in the ...

BACKGROUND: Vasospasm is a potentially devastating complication after aneurysmal subarachnoid hemorrhage. Although endovascular treatment with intraarterial nicardipine and milrinone is an accepted clinical treatment strategy, there is little information either on hemodynamic management during treatment or on outcome and consequences of the hemodynamic management. We tested 2 hypotheses: (1) intraarterial ...

Endothelin is important in the development of cardiorenal disease. This review discusses recent developments in understanding endothelin's role in hypertension and chronic kidney disease (CKD). Endothelin-1 production is increased in hypertension and CKD. Endothelin-1 stimulates vasoconstriction, inflammation and fibrosis, thereby promoting hypertension, atherosclerosis and CKD. These effects are closely linked ...

The Hypertension in the Very Elderly trial (HYVET), demonstrated the benefit of antihypertensive treatment in patients >or=80 years. However, patients in this age group are at increased risk of drug interactions and adverse effects. We conducted a retrospective cohort study, in hypertensive patients aged >or=80 years, to determine whether it ...

In some controlled therapeutic trials for hypertension, a selective reduction of systolic blood pressure has been obtained with long-term treatment. The greatest effects on cardiovascular outcomes stem from a decrease of central blood pressure through a significant reduction of arterial stiffness, wave reflections, or both. Until now, all protocols have ...

Clevidipine butyrate is an ultrashort-acting intravenous dihydropyridine calcium-channel blocker that has been approved by the FDA for the reduction of blood pressure when oral therapy is not feasible. Hypertension is a global disease that affects more than 1 billion people worldwide and 75 million people in the USA. There are ...

IMPORTANCE OF THE FIELD: Osteoarthritis and hypertension commonly co-exist. Treatment of osteoarthritis in hypertensive patients is a therapeutic challenge due to the adverse effects of some analgesics, especially non-steroidal anti-inflammatory drugs (NSAIDs), on blood pressure. Even small drug-induced rises in blood pressure due to therapy may significantly increase cardiovascular risk ...

RATIONALE, AIMS AND OBJECTIVES: Compliance with treatment guidelines for hypertension is variable. This study assessed the competence of Polish general practitioners in compliance with hypertension treatment guidelines, and doctor and patient characteristics associated with compliance. METHODS: The study was conducted on a random sample of Polish primary-care doctors working in ...

An innovative approach to the therapy of essential hypertension (EH) and the related complications has been pursued by our group with the aim of defining specific genetic-molecular mechanisms underlying the disease in sub-sets of patients. This approach is anticipated to have a major effect on the clinical practice, diagnostics and ...

Hypertension remains a significant health problem, affecting approximately 30% of the US population. Of these, only 36.8% have BP controlled to recommended levels of <140/90 mmHg for uncomplicated hypertension and <130/80 mmHg for patients with diabetes mellitus or renal disease. For those with uncontrolled hypertension, the risk of diabetes, renal disease, stroke, ...

BACKGROUND: Hypertension is an important healthcare challenge, yet despite initiatives to improve detection and advances in therapy, the majority of patients do not achieve recommended blood pressure targets and remain at high cardiovascular risk. Physicians are confronted with an array of antihypertensive agents, accompanied by increasingly complex and often conflicting ...

It has long been noted that religious congregations tend to be racially homogenous. Previous case studies assert that members of a numerical minority group face individual and organizational pressures that lead them to leave congregations faster than majority members. This can create a constant pull toward homogeneity despite congregational efforts ...

Meticulous control of blood pressure is required in patients with hypertension to produce the maximum reduction in clinical cardiovascular end points, especially in patients with comorbidities like diabetes mellitus where more aggressive blood pressure lowering might be beneficial. Recent clinical trials suggest that the approach of using monotherapy for the ...

The objective of this review is to assess the clinical evidence for or against cupping as a treatment for hypertension. We searched the literature using 15 databases from their inception to 30 June 2009, without language restrictions. We included all clinical trials (CTs) of cupping to treat hypertension in human ...

Every third adult in the United States has hypertension. Hypertension is a continuous, independent, potent risk factor for cardiovascular events like stroke, myocardial infarction, and heart failure. The blood pressure control achieved with most hypertensives is way below the recommended goal. Recent trials suggest that for nearly half of hypertensive ...

Early initiation of rational and effective combination therapy consisting of antihypertensive drugs with two different and complementary mechanisms of actions is increasingly becoming accepted in clinical practice and by guidelines as a first-line approach to control blood pressure (BP) and prevent cardiovascular outcomes in patients with hypertension. Once-daily combination therapy ...

The European Society of Hypertension Task Force document on reappraisal of the 2007 European guidelines on hypertension addresses a number of studies published in the last 2 years to estimate their contribution to the expanding knowledge on hypertension. The importance of total cardiovascular risk with inclusion of subclinical cardiac, vascular, ...

Rural populations across the United States have an increased likelihood of developing hypertension and diabetes, which are significant risk factors for cardiovascular disease (CVD), including stroke and myocardial infarction. Limited access to care due to geography or socioeconomic status significantly impairs control of hypertension in rural populations, resulting in poor ...

Hypertension is one of the major risk factors associated with cardiovascular diseases. A range of blood pressure-lowering agents is available including diuretics, alpha- and beta-blockers, aldosterone antagonists, calcium-channel blockers (CCB), angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB) and direct renin inhibitors (DRI). Most patients require two or more ...

Hypertension is one of the most distinguishing features of endogenous Cushing's syndrome (CS), as it is present in about 80% of adult patients whereas in children its prevalence is about 47%. Hypertension in CS is significantly correlated with the duration of hypercortisolism and results from the interplay between several pathophysiological ...

Patient adherence to antihypertensive medication is vital to ensure the successful treatment of hypertension. Low levels of adherence to and persistence with prescribed therapy are major factors leading to the current poor rates of blood pressure control among patients with hypertension. There are many reasons for nonadherence to therapy including ...